NPI | 1366605511 |
---|---|
Former Name | SUSAN M WENZELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LJ00000110) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE LJ-0000110) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2012-02-14 |